Notes in LE027_Iron_Deficiency_Anemia

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Published	10/14/2024	Anemia is a condition in which the blood is deficient in (3) {{c1::red blood cells}}, in {{c1::hemoglobin}}, or in {{c1::total volume}}, resulting in …
Published	10/14/2024	Microcytosis is caused by defects in {{c1::hemoglobin synthesis}}
Published	10/14/2024	Microcytosis is defined as mean corposcular volume (MCV) of less than {{c1::80fL}}
Published	10/14/2024	Normocytosis is defined as mean corposcular volume (MCV) between {{c1::80fL - 100fL}}
Published	10/14/2024	Macrocytosis is defined as mean corposcular volume (MCV) of greater than {{c1::100fL}}
Published	10/14/2024	Macrocytosis can be caused by (3) {{c1::defects in DNA synthesis, alcohol, and  drugs}}
Published	10/14/2024	What 4 causes of anemia can present with normocytosis?
Published	10/14/2024	Most environmental iron is in the {{c1::Fe3+}} formThis is (strongly/poorly) {{c2::poorly}} soluble at physiologic pH
Published	10/14/2024	Iron circulates in the plasma bound to carrier protein {{c1::transferrin (Tf)}}Iron bound to {{c1::Tf}} is taken up by cells, including RBCs
Published	10/14/2024	Transferrin in the iron-bound state is named {{c1::holo-Tf}}Absent bound iron, it is named {{c1::apo-Tf}}
Published	10/14/2024	A small fraction of our iron comes from {{c1::our diet}} (1-2 mg/day, absorbed in {{c1::duodenum}})
Published	10/14/2024	Most of our iron (25 mg/day) comes from {{c1::macrophage phagocytosis of mature RBC}}
Published	10/14/2024	The bone marrow requires iron for {{c1::RBC production/maturation}}
Published	10/14/2024	Excess iron is stored in the {{c1::liver}}, our main iron depot
Published	10/14/2024	Iron is required by organs including (3) {{c1::the heart, muscle, and pancreas}}
Published	10/19/2024	Systemic iron balance is regulated at the level of {{c1::intestinal absorption}}
Published	10/14/2024	Iron is lost in small amounts through {{c1::epithelial shedding from skin and GI tract (and menstruation)}}
Published	10/14/2024	Hepcidin is a small (steroid/peptide) {{c1::peptide}} hormone released by {{c2::hepatocytes}} into the bloodstream
Published	10/14/2024	Hepcidin functions to (limit/increase) {{c1::limit}} iron entry into circulation
Published	10/14/2024	Hepcidin regulates iron entry into circulation at two major sites: {{c1::enterocytes and macrophages}}
Published	10/14/2024	What is the mechanism by which hepcidin limits iron uptake?
Published	10/14/2024	The expression of hepcidin is modulated in response to changes in {{c1::liver iron stores}}
Published	10/14/2024	When iron stores increase, hepcidin production {{c2::increases}}The net effect is prevention of {{c2::systemic iron overload}}
Published	10/14/2024	Iron deficiency anemia develops when {{c1::iron supply to the bone marrow}} fails to meet {{c1::iron needs for hemoglobin synthesis}}
Published	10/14/2024	What factors trigger the development of iron deficiency? (3)
Published	10/14/2024	What is the most common cause of iron deficiency anemia in adults over the age of 65 years?
Published	10/14/2024	What is the most common cause of iron deficiency anemia in adults over the age of 65 years?
Published	10/14/2024	In infants and children, the common etiologies of IDA are (2):{{c1::Inadequate iron intakeIncreased iron requirements due to growth spurts}}
Published	10/14/2024	In premenopausal women, the common etiologies of IDA are (2):{{c1::Menstrual blood lossPregnancy with inadequate intake}}
Published	10/14/2024	In adult men and postmenopausal women, the common etiologies of IDA are (2):{{c1::Blood loss due to tumor, peptic ulcer, or bleeding from GI/GU tractM…
Published	10/14/2024	{{c1::Iron deficiency}} is the most common cause of anemia worldwide
Published	10/14/2024	The first step in the development of IDA is {{c1::the metabolism of iron from storage sites in an attempt to maintain iron levels in the circulation}}
Published	10/14/2024	The depletion of iron stores eventually leads to a reduction in amount of {{c1::transferrin-bound iron}} in the circulation
Published	10/14/2024	Inadequate iron delivery to the bone marrow results in decreased {{c1::RBC production and decreased release into the circulation}}
Published	10/14/2024	Common clinical findings in IDA include symptoms relate to reduced O2 delivery to tissuesIn severe cases, this includes: {{c1::pallor, weakness, dizzi…
Published	10/14/2024	Physical exam findings common in chronic IDA (3):{{c1::Koilonychia: spooning of the nailsAngular cheilitis: ulcers/fissures at the angles of…
Published	10/14/2024	Lab findings common in IDA (3):{{c1::Hypochromia and microcystosis (in severe IDA and a minority of RBCs in less severe ID)Anisocytosis: variation in …
Published	10/14/2024	Which of the following RBC indeces is characteristically elevated in patients of IDA?A. RBCB. MCVC. Reticulocyte countD. RCDW
Published	10/14/2024	Which RBC parameters are consistent with hypochromic and microcytic anemia? {{c1::Low}} Hemoglobin (Hgb) level • Mass of Hgb per volume of wh…
Published	10/14/2024	Which parameters can distinguish IDA from other causes of microcytic anemia?{{c1::Low}} RBC Count • Number of RBCs per unit volume of sample (cel…
Published	10/14/2024	Serum iron is a measure of {{c1::iron bound to transferrin}} in the patient's blood
Published	10/14/2024	Total iron binding capacity is an indirect measure of {{c1::transferrin concentration}}It is the concetration needed to fully saturate all Tf binding …
Published	10/14/2024	Transferrin (iron) saturation is calculated as {{c1::serum iron/TIBC x 100}}
Published	10/14/2024	Total iron binding capacity (TIBC) is {{c1::increased}} in ID due to the compensatory increase in transferrin synthesis by the liver
Published	10/14/2024	Ferritin is the {{c1::intracellular}} storage form of iron. A small proportion circulates in the plasma, secreted by {{c1::macrophages}}
Published	10/14/2024	Bone marrow biopsy is the gold standard for evaluating {{c1::marrow iron stores}} (with macrophages)
Published	10/14/2024	What is Free Erythrocyte Protoporphyrin (FEP) and what is its utility as a laboratory test for IDA?
Published	10/14/2024	The earliest laboratory abnormality detected during the development of iron deficiency is: Increased total iron binding capacity (TIBC) Decr…
Published	10/14/2024	Diagnosis of iron deficiency depends on demonstration of an adequate response to {{c1::iron therapy}}
Published	10/14/2024	Treatment with iron therapy can consist of (2):{{c1::Oral administration of ferrous saltParenteral administration of iron in cases of malabsorption}}
Published	10/14/2024	Response to iron therapy is assessed by monitoring {{c1::Hgb levels}} and {{c1::reticulocyte}} count
Published	10/14/2024	Alongside treatment of IDA, what else must be done?
Published	10/14/2024	Anemia of chronic disease is also known as {{c1::anemia of inflammation}}
Published	10/14/2024	Anemia of chronic disease is a complex form of anemia seen in patients with (3) {{c1::infection, inflammatory states, and cancers}} that is charac…
Published	10/14/2024	Distinguish plasma hepcidin changes between IDA and ACD
Published	10/14/2024	Distinguish peripheral smear changes between IDA and ACD
Published	10/14/2024	Distinguish serum iron changes between IDA and ACD
Published	10/14/2024	Distinguish TIBC changes between IDA and ACD
Published	10/14/2024	Distinguish transferrin saturation (TS) changes between IDA and ACD
Published	10/14/2024	Distinguish serum ferritin changes between IDA and ACD
Published	10/14/2024	Distinguish soluble transferrin receptor changes between IDA and ACD
Published	10/14/2024	Sideroblastic anemias are a group of disorders characterized by abnormal {{c1::heme synthesis}}
Published	10/14/2024	Sideroblastic anemias have both {{c1::hereditary (rare, often X-linked)}} and {{c1::acquired (caused by alcohol, drugs or myelodysplastic syndromes)}}…
Published	10/14/2024	In sideroblastic anemia, iron is trapped in {{c1::erythroid mitochondria}} and unavailable for {{c1::heme synthesis}}
Published	10/14/2024	Sideroblastic anemia is diagnosed by finding {{c1::ringed sideroblasts}} on (location) {{c1::bone marrow examination}}
Published	10/14/2024	In sideroblastic anemia, erythroid defect is accompanied by low {{c1::hepcidin}} and increased {{c1::dietary iron absorption}}, leading to systemi…
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